Interactive Video Technology Research Articles

P4-343: Telehealth home monitoring of solitary persons with mild dementia

Medication safety is a special concern for the 30–40% of dementia patients that live alone at time of diagnosis and plays an important part in relocation decisions. We hypothesized that televideo monitoring could improve medication self–administration accuracy and improve mood for persons with mild dementia that live alone, or spend a significant amount of their day alone. Over two years the Mayo Foundation and Minnesota Department of Human Services supported the Mayo Alzheimer's Disease Research Center, in utilizing two–way interactive video technology to provide remote supervision of 12 persons with mild dementia. We used the technology primarily to monitor medication and meal compliance. We conducted more than 4000 contacts with these persons and found adequate technical outcome in 82% of calls. End medication compliance was 81% in our video monitored group compared to 66% in our controls (p<.05). Comparison of compliance from initial to end ratings revealed that video monitored participants compliance remained stable (change of .0.7 percentage points) while unmonitored patients compliance fell 12 percentage points, consistent with expectations for dementia. This difference was also significant. This study demonstrated that persons with MCI and mild dementia could be monitored without technical difficulty. Monitoring reduced deterioration in medication self–adminstration. Qualitative feedback from caregivers about the program was generally positive. Additional research to determine impact of this type of intervention on relocation and other outcomes is needed.

Context-aware support in structured documents for interactive-TV

Interactive video technology has demanded the development of standards, techniques and tools to create, deliver and present interactive content and associated metadata. The literature reports on models representing interactive-TV (I-TV) programs --- one of the main applications of the interactive video technology; the limitation of such models include: strict hierarchical relationships among media objects, low levels of granularity for metadata, programs and media objects descriptions cannot be separated, objects are not described beyond the frame level, lack of integration with context-aware computing. In this paper, we detail features of our MediaObject model for documents describing I-TV programs that aim to minimize those limitations. We discuss the model by means of an application that is part of our I-TV prototype and by an annotation tool that shows that the model can be applied to other domains.

Drive-by English: Teaching College English to High School Students via Interactive TV

This paper outlines challenges in and essential criteria for the success of dual-credit or concurrent-enrollment writing and literature courses delivered via interactive video technology and suggests specific strategies for administrators, instructors, and classroom facilitators regarding student selection, appropriate technology, and classroom management.

Interactive Video Technology for Distance Learning

By comparing two classes (onsite and remote), this study assesses the influence of interactive video technology on how students learn in one library and information science (LIS) distance learning course. Students in this course participated voluntarily in the study by completing a questionnaire, and some elected to participate in a focus group at the end of the course. The results revealed that students in both classes became more comfortable with the technology, had positive attitudes, and achieved the learning objectives for the course. Students identified the top three positive factors that enhanced their learning as (1) class discussions with more diverse perspectives, (2) use and familiarity with the technology, and (3) class interactions. Students identified the top three negative factors that hindered their learning as (1) audio problems, (2) technology glitches and delays, and (3) intimidation to participate by the large screen, with two large classes and talking heads visible to everyone. In conclusion, the benefits of interactive video far outweigh the barriers.

Distance Education: Using Compressed Interactive Video Technology for an Entry-Level Doctor of Pharmacy Program

New responsibilities for faculty members and changing student perspectives have occurred with the establishment of an entry-level Doctor of Pharmacy program delivered by compressed interactive video (CIV). The purpose of this article is to describe the experiences of distant site faculty and make recommendations for the successful use of CIV technology in an entry-level Doctor of Pharmacy program. Information obtained from the literature was used in conjunction with the authors' experience to discuss the roles and responsibilities of a distant site facilitator, problems encountered when delivering instructional material via CIV, and recommendations for effective teaching via CIV. Future plans and research questions are also addressed.

Technological advances and telehealth: Ethics, law, and the practice of psychotherapy.

Advances in technology are rapidly changing the practice of psychotherapy. Psychotherapists may now offer clinical services around the world by telephone and via the Internet by e-mail, chat rooms, Web sites, and interactive audio and video technology. The many new media and resources available to practitioners are reviewed along with the potential benefits as well as the ethical and legal challenges and dilemmas that place the unwary or ill-informed practitioner at great risk. Recommendations for effective clinical and ethical practice are made to assist the practitioner using these technologies to provide clinical services.

Participant Satisfaction with a School Telehealth Education Program Using Interactive Compressed Video Delivery Methods in Rural Arkansas

Socioeconomic and demographic factors can affect the impact of telehealth education programs that use interactive compressed video technology. This study assessed program satisfaction among participants in the University of Arkansas for Medical Sciences' School Telehealth Education Program delivered by interactive compressed video. Variables in the one-group posttest study were age, gender, ethnicity, education, community size, and program topics for years 1997-1999. The convenience sample included 3,319 participants in junior high and high schools. The School Telehealth Education Program provided information about health risks, disease prevention, health promotion, personal growth, and health sciences. Adolescents reported medium to high levels of satisfaction regarding program interest and quality. Significantly higher satisfaction was expressed for programs on muscular dystrophy, anatomy of the heart, and tobacco addiction (p < 0.001 to p = 0.003). Females, African Americans, and junior high school students reported significantly greater satisfaction (p < 0.001 to p = 0.005). High school students reported significantly greater satisfaction than junior high school students regarding the interactive video equipment (p = 0.011). White females (p = 0.025) and African American males (p = 0.004) in smaller, rural communities reported higher satisfaction than White males. The School Telehealth Education Program, delivered by interactive compressed video, promoted program satisfaction among rural and minority populations and among junior high and high school students. Effective program methods included an emphasis on participants' learning needs, increasing access in rural areas among ethnic groups, speaker communication, and clarity of the program presentation.

Clinical Performance Assessment and Interactive Video Teleconferencing: An Iterative Exploration

Background: The direct observation of students in authentic settings by faculty provides valuable feedback on performance and helps ensure mastery of clinical skills. Description: We explored the use of interactive video technology (IVT) as a way of involving community preceptors as raters on a clinical performance exam for 3rd-year students after their family medicine clerkship. Family medicine preceptors, from locations in their communities, observed students on campus conduct interviews and physical exams of standardized patients and then interacted with them during their case presentations. Evaluation: We chose an action research approach to this project and conducted four independent trials. Interviews and observations were structured around three areas of concern: human, technical, and institutional. Conclusions: We feel confident in recommending IVT as a viable option for involving community preceptors in high-stakes testing and with other campus-based activities. We also report on the value of IVT in faculty development activities.

The future of simulators in GI endoscopy: An unlikely possibility or a virtual reality?

The future of simulators in GI endoscopy: An unlikely possibility or a virtual reality?

Telehealth and Telenutrition

The use of interactive compressed video technology to provide nutrition counseling for elderly patients in limited-resource rural areas is described. The application of telehealth principles by registered dietitians to deliver medical nutrition therapy is termed tele-nutrition and is well received by rural elderly.

Implementation and evaluation of a telemedicine course for physician assistants.

Clinical telemedicine uses interactive video technologies and telecommunications networks to deliver medical consultations to distant patients and their primary care providers. Telemedicine provides real-time access to specialists whose services might not otherwise be available in rural or medically underserved areas. While recently there has been dramatic growth in the use of telemedicine, there is little evidence that telemedicine as a patient care delivery system has been incorporated into the medical school curriculum. The authors describe the current status of telemedicine in medical curricula and report on efforts at the University of Iowa to incorporate telemedicine into the curriculum of its Physician Assistant Program.

School-based telehealth: an empirical analysis of teacher, nurse, and administrator perceptions.

In 1997, the University of Kansas Medical Center (KUMC) and the United School District 500 (USD 500) in Kansas City, Kansas, launched an innovative telehealth project that brought health care directly into elementary schools by interactive video technology and peripheral devices. This paper focuses on the attitudes and opinions of key players--teachers, nurses, and administrators--involved in providing the service. Research methodology involved analyzing archival data and conducting interviews with key players on the project from USD 500 and KUMC. The study highlights the difficulty in delivering health care, especially telehealth care, to underserved, urban children. The data also reveal that initial challenges and negative attitudes can be overcome to effectively deliver telehealth care in the school setting.

How accurate are chronic wound assessments using interactive video technology?

This project examined the accuracy of chronic wound assessments made using an interactive, video telecommunications system (Teledoc 5000, NEC America, Inc., Irving, TX) by comparing a nurse expert's in-person wound assessments with wound assessments made from taped Teledoc sessions. Wound assessments determined the absence or presence of nine wound characteristics instrumental in guiding treatment (e.g., tunneling, undermining, granulation tissue, necrotic tissue, epithelial tissue, purulent exudate, erythema, edema, induration). A sample of 13 paired wound observations was analyzed. The accuracy of the Teledoc technology was examined by calculating the amount of agreement between the in-person assessments and the taped Teledoc assessments for each of the nine characteristics. Agreement for eight of the nine wound characteristic exceeded 75%, suggesting this telehealth medium does not alter wound assessment data, which are essential in guiding treatment decisions. In addition to connecting the remotely based nurse with nursing expertise to improve patient care, telehealth technology seemed to increase the remotely-based nurses' knowledge of wound assessment and treatment as well.

A Nursing Application Of Telecommunications

Consumer and provider satisfaction is key to the continued use and expansion of telehealth technology. This pilot study compared satisfaction of providers and patients with wound consultations done in person with those done via real-time interactive video technology. Eleven telehealth consultations with a nurse expert were immediately followed by an in-person consultation with a second nurse expert. Satisfaction questionnaires were administered to patients, referring nurses, and the consultant nurse expert following both the in-person consultation and the telehealth consultation. The referring nurses (100%) were satisfied with both the telehealth and in-person consultations, noting the ability to provide better care for their patients. The patients (55%) were "very satisfied" with the telehealth consultations versus 40% satisfied with the in-person consultations. Difficulty in hearing for the patients was equal in both groups, which resulted in changes in the consultation process. The patients' difficulty in seeing the telehealth consultant was addressed through larger screens and strategic positioning to provide easier viewing for the patient and providers. The telehealth nurse consultant was satisfied overall but had some difficulty communicating. This pilot study helped provide useful information for both the telehealth and in-person consultations.

Bridging the Gap: Challenges and Prescriptions for Interactive Distance Education

As interactive distance education gains prominence in management education, fanfare about the technology has overshadowed how the distance mode affects the learning context. This article addresses the gap between the technology focus and the learning environment. The authors categorize three specific challenges posed by interactive distance education: (a) the challenge of the technology delivery, (b) the challenge of the work-site context, and (c) the challenge to the student/professor relationship. Because others have written about the technology delivery, the authors focus on the work-site dynamic and the context of learning and offer prescriptions for managing these critical dynamics more effectively. The work is based on one of the author’s MBA organizational behavior classes offered via interactive video technology to seven off-campus sites simultaneously and is supplemented with field observation, student surveys, and interviews.

Teaching using interactive video: creating connections.

This article addresses the two essential elements of distance learning: the technology and the pedagogy. Both areas are discussed through the four components--information, support, resources, and relationships--of a work effectiveness model. Drawing from recent literature and their experience, the authors offer strategies for making interactive video technology "invisible" while engaging students at a distance. Students experience connections when faculty know how to manage the equipment, plan ahead, and consciously construct strategies for creating relationships across the miles.

A Model for Developing and Managing Distance Education Programs Using Interactive Video Technology

Based on two years of experience with a distance MSW program, the authors present an evolving model for the development, management, and evaluation of distance education graduate programs that use interactive video technology. The model includes five core components: (a) accreditation standards compliance, (b) resource requirements, (c) curriculum adaptation, (d) faculty development, and (e) program evaluation. While not an exhaustive listing, these components are advanced as central to the effective planning and administration of distance education programs in social work.

Participant interaction in a course delivered by interactive compressed video technology

Fully interactive learning environments have been demonstrated to increase student satisfaction, learning, and retention in the educational environment. Using Moore's (1989) framework for interaction in distance education settings, this study investigated participant interactions in a course delivered to five sites by interactive compressed video (ICV) technology. The purpose of this study was two‐fold—to determine the extent to which participants took advantage of opportunities for interaction and to note their perceived barriers to interaction. The participants failed to take full advantage of the opportunities for interaction provided in the course context. Seven barriers to interaction, which focused on ICV technology limitations and student situational and dispositional characteristics, were identified. Implications for practice and future research are discussed at the conclusion of the study.

Effect of a Remote Facilitator on Small-Group Problem Solving: Potential Uses of Two-Way Video Technology in Decentralized Medical Education

Background: As more of medical education becomes decentralized to off-campus sites, the ability of campus faculty to monitor the development of student problem-solving skills becomes more limited. Purpose: This study addressed the acceptability of providing a remote facilitator by telephone or full-motion interactive video, as well as measuring the effect on group process in each of the three facilitator arrangements. Methods: Three groups of clerkship students were facilitated first on site, then by interactive video, then by telephone only. Results: Both off-site methods proved acceptable, but students felt that they increased their content knowledge more in on-site and video sessions. There were no differences in group interactions. In the on-site and telephone groups, the facilitators tended to be the predominant questioners; in the video group, the students asked more questions of the facilitator. Conclusions: In the sequence used, interactive video technology had the same or more positive effects on measured variables when compared to an on-site facilitator.

Extension Program Delivery for Greenhouse Growers Using Compressed Video Technology

There is a need for educational programming for greenhouse growers on effective uses of biorational pesticides and biological controls of insect and mite pests, diseases, and alternatives to herbicide sprays in confined areas; however, in many states, travel for specialists for programming and workshops is becoming prohibitive. A series of programs outlining Best Management Practices (BMP) for the greenhouse industry outlining techniques and practices reducing pesticide use were conducted at multiple sites in Colorado simultaneously using interactive compressed video technology. This conferencing technology is gaining wide acceptance in many venues and provides an opportunity for wider participation of clientele without travel. Participants in the programs reported in post-session evaluations that they did miss the personal interaction with the speakers, but did acknowledge that not having to drive 5 hours to attend a seminar was quite beneficial.